Individual provider · NPI-1

Joanna Lang, PA

Physician Assistant · Oak Creek, WI

NPI number1245526334
StatusActive
Last updated in NPPESJun 27, 2011

Details

NPI
1245526334
Entity type
Individual (NPI-1)
Name
Joanna Lang
Credential
PA
Sex
Female
Sole proprietor
No
Enumeration date
Jun 27, 2011
Last updated
Jun 27, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant2795WIYes

Practice location

335 E Mahn Ct
Oak Creek, WI 53154-2155

Phone 414-762-2020 · Fax 414-762-2024

Mailing address

335 E Mahn Ct
Oak Creek, WI 53154-2155

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